Provider Demographics
NPI:1992057871
Name:WHITE, LINDSAY (OTR/L)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 MARCH ST
Mailing Address - Street 2:APT 1A
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-6881
Mailing Address - Country:US
Mailing Address - Phone:207-532-8169
Mailing Address - Fax:
Practice Address - Street 1:22 MARCH ST
Practice Address - Street 2:APT 1A
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-6881
Practice Address - Country:US
Practice Address - Phone:207-532-8169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-03
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT2694225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist